Discusses aortic valve regurgitation. Discusses symptoms and how it is diagnosed. Covers treatment with medicines and aortic valve replacement surgery. Covers lifestyle changes to help the heart work better.

Aortic Valve Regurgitation

Overview

What is aortic valve regurgitation?

Aortic valve
regurgitation is a problem with the aortic valve. The aortic valve allows blood to flow from the heart's lower left chamber (ventricle) into the aorta and to the body. When the heart
rests between beats, the valve closes to keep blood from flowing
backward into the heart.

When you have aortic valve
regurgitation, the aortic valve doesn't close as it should. With each heartbeat, some of the blood leaks back (regurgitates) through the aortic valve
into the left ventricle. The body does not get enough blood, so the heart has
to work harder to make up for it. See a picture of
aortic valve regurgitation.

You can have this problem for a long time and not know it. It may take years for symptoms to start. This is called chronic aortic valve regurgitation. In rare cases, the valve problem starts suddenly and without warning. This is called acute aortic valve regurgitation. It requires medical help right away.

What causes aortic valve regurgitation?

Any
condition that damages the aortic valve can cause aortic valve regurgitation.
Common causes of chronic valve problems include:

Being born with a damaged aortic
valve.

Aging.

Enlargement of the aorta because of high
blood pressure or hardening of the arteries.

Rheumatic
fever.

The most common causes of sudden (acute) aortic valve regurgitation include:

Endocarditis, which is an infection in the
heart.

Aortic dissection, which means that the inner layer of
the aorta separates from the middle layer.

What are the symptoms?

For chronic regurgitation, you may not have any symptoms at first. But over time you may have:

Fatigue or weakness.

Shortness of
breath, most often when you are active.

A fast, slow, or uneven
heartbeat (arrhythmia).

A feeling that your heart is pounding,
racing, or beating unevenly (palpitations).

Chest pain or pressure
(angina), often brought on by exercise, when the heart
has to work harder.

Fainting.

When the valve problem is acute, these symptoms are
sudden, often more intense, and life-threatening.

How is aortic valve regurgitation diagnosed?

Your
doctor may suspect that you have this type of valve problem after hearing a
heart murmur through a
stethoscope. He or she will ask about your symptoms
and past health and will want to know if you have any family history of heart
disease.

You will get further tests, like an
echocardiogram to confirm the
diagnosis, to show how much the valve is leaking, and to see how well the left
ventricle is working.

How is it treated?

Your treatment will depend on
what is causing your valve problem and if you have symptoms.

Cause

Chronic aortic valve regurgitation

Causes of
chronic
aortic valve regurgitation include:

Congenital heart defects. Some people are born with a valve that has one
(unicuspid valve) or two leaflets (bicuspid valve) instead of three. In either of these cases, the valves don't close the way they should when the heart is at rest.

Aging.
The normal wear and tear of aging can affect the valves.

Endocarditis. This is an infection in the heart. Bacteria caused by infection can prevent the valve from closing properly.

Enlarged aorta. This can be caused by age or other health problems, such as high blood pressure.

The diet medicine fen-phen. Fen-phen was
a popular diet drug that was taken off the U.S. market in 1997 because of its
link to heart valve disease, including aortic valve regurgitation.

Rheumatic fever. If you had rheumatic fever, you may be at increased risk for aortic valve regurgitation.

Radiation treatments for cancer. In rare cases,
radiation treatments to the chest, especially in young
people, can damage the aortic valve.

Tell your doctor if one of your close family members has a
congenital aortic valve defect. This may also increase your risk.

When to Call a Doctor

Call your doctor
if you have symptoms of
aortic valve regurgitation such as fainting, chest
pain, or shortness of breath. Your doctor will confirm whether you have valve problems or some
other condition. For more information, see Symptoms.

Treatment Overview

Treatment for
aortic valve regurgitation usually depends on whether
you have symptoms from your leaky heart valve and how well your heart is pumping. Other things that affect treatment include your age and risks related to surgery.

Tests to assess

You'll need regular echocardiogram tests as part of your treatment. Your doctor will let you know how often you'll get these tests. For more information, see Exams and Tests.

Monitor your symptoms

If you have any chest pain or pressure, fainting, or
shortness of breath, be sure to tell your doctor right away. He or she will rely on you to report how you feel and how your symptoms are changing.

Medicines to manage

If your regurgitation is mild and you don't have any symptoms, you doctor may not prescribe medicines. If your regurgitation is moderate to severe, your doctor may prescribe a blood pressure medicine. For more information, see Medications.

Lifestyle changes

Because your heart is already working hard to keep up with your body's needs, your doctor will probably recommend that you make some healthy lifestyle changes. These include eating a heart-healthy diet and not smoking. For more information, see Living With Aortic Regurgitation.

Surgery if you get worse

You will likely have surgery to replace your aortic valve if your regurgitation is getting worse. You might have surgery before you get symptoms. If you have acute regurgitation, surgery may be done right away. For more information, see Surgery.

End-of-life care

If you have symptoms and don't have surgery, you will likely develop severe heart failure and have a much shorter life span. So it's important to think about end-of-life issues. You may want to consider the type of care you wish to receive in case you are unable to make your wishes known. For more information, see the topic
Care at the End of Life.

Living With Aortic Regurgitation

Having
aortic valve regurgitation means that your heart is working
overtime to keep up with your body's needs. Your doctor will probably suggest
lifestyle changes to help your heart.

Make healthy lifestyle changes

If you smoke, try to quit. Medicines and counseling can help you quit for good.

Your doctor will also
recommend that you follow a
heart-healthy diet and
limit how much salt you eat.

If you don't have symptoms of aortic valve regurgitation and your left ventricle is working well, your doctor may suggest
regular, light aerobic exercise, such as walking. But don't start an exercise
program on your own without first talking with your doctor. You may need some tests to see what sort of exercise is safe for you.

If you need to lose weight, try to reach and stay at a healthy weight. For help, see the topic Weight Management.

Take care of yourself

Report any symptoms of
chest pain or pressure, fainting, and shortness of breath to your doctor right away. These
are signs that you are likely to need surgery.

See your doctor regularly, and get the tests you need to assess your heart, such as echocardiograms. For more information, see Exams and Tests.

Practice good dental hygiene and have regular checkups.
Good dental health is especially important, because bacteria can spread from
infected teeth and gums to the heart valves.

Get a
flu shot every year.

Medications

Treatment for chronic
aortic valve regurgitation includes medicines to
reduce blood pressure. If you have valve replacement surgery, you will need to
take medicines to prevent infection and blood clots around the artificial
valve.

Medicines to reduce blood pressure

If your regurgitation is moderate to severe, your doctor may
prescribe blood pressure medicine such as:

Surgery

Valve replacement surgery is the only
cure for aortic valve regurgitation. Having surgery is a big decision. To help decide when you need surgery, you and your doctor will look at your overall health, your heart health, and how severe your regurgitation is.

If you have surgery, a mechanical or tissue valve will be used to replace your heart valve. Before you have surgery, you and your doctor will decide on which type of valve is right for you. To help with this decision, see:

Other Places To Get Help

Organizations

Society of Thoracic Surgeons

633 North Saint Claire Street

Floor 23

Chicago, IL 60611

Phone:

(312) 202-5800

Fax:

(312) 202-5801

Web Address:

www.sts.org

The Society of Thoracic Surgeons provides patient information on surgeries of the chest and throat that are done by cardiothoracic surgeons. These surgeries include heart, lung, and throat surgery. The patient information section of the website describes diseases, surgeries, patient options, and what to expect after surgery. And using the website, you can search for surgeons in your area.

American Heart Association (AHA)

7272 Greenville Avenue

Dallas, TX 75231

Phone:

1-800-AHA-USA1 (1-800-242-8721)

Web Address:

www.heart.org

Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.

National Heart, Lung, and Blood Institute
(NHLBI)

P.O. Box 30105

Bethesda, MD 20824-0105

Phone:

(301) 592-8573

Fax:

(240) 629-3246

TDD:

(240) 629-3255

Email:

nhlbiinfo@nhlbi.nih.gov

Web Address:

www.nhlbi.nih.gov

The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
and treating:

Related Information

References

Citations

Bonow RO, et al. (2008). 2008 Focused update
incorporated into the ACC/AHA 2006 Guidelines for the management of patients
with valvular heart disease: A report of the American College of
Cardiology/American Heart Association Task Force on Practice Guidelines
(Writing committee to revise the 1998 Guidelines for the management of patients
with valvular heart disease). Circulation, 118(15):
e523–e661.

Other Works Consulted

Bonow RO, et al. (2008). 2008 Focused update
incorporated into the ACC/AHA 2006 Guidelines for the management of patients
with valvular heart disease: A report of the American College of
Cardiology/American Heart Association Task Force on Practice Guidelines
(Writing committee to revise the 1998 Guidelines for the management of patients
with valvular heart disease). Circulation, 118(15):
e523–e661.

Rosengart TK, et al. (2008). Percutaneous and minimally invasive valve procedures: A scientific statement from the American Heart Association Council on Cardiovascular Surgery and Anesthesia, Council on Clinical Cardiology, Functional Genomics and Translational Biology Interdisciplinary Working Group, and Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation, 117(13): 1750–1767.

Bonow RO, et al. (2008). 2008 Focused update
incorporated into the ACC/AHA 2006 Guidelines for the management of patients
with valvular heart disease: A report of the American College of
Cardiology/American Heart Association Task Force on Practice Guidelines
(Writing committee to revise the 1998 Guidelines for the management of patients
with valvular heart disease). Circulation, 118(15):
e523–e661.

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